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The Living Organ Volunteer Engagement (LOVE) Act
Increasing living kidney donations saves lives and reduces Medicare costs.
94,000+
Americans
are currently waiting for a kidney transplant.
Americans
The wait list
grows every year
Patients wait an average of 3-5 years.
grows every year
Every day,
12-17 people die
before a kidney becomes available.
12-17 people die
~6,500
Living Donor Transplants
performed yearly with little change for 20+ years.
Living Donor Transplants
The LOVE Act is a direct, evidence-based approach to changing this.
Why Living Donation Matters
Living kidney donation is safe, ethical, and produces better outcomes for patients. Living donor kidneys last nearly twice as long as deceased donor kidneys – 14 to 16 years of function compared to fewer than 10 years on dialysis.
Yet living donation has stagnated, remaining essentially flat for over two decades even as deceased donor transplants more than doubled. In 2025, overall kidney transplants declined for the first time this century due to a drop in deceased donations making the need to increase living donation more urgent than ever.
Yet living donation has stagnated, remaining essentially flat for over two decades even as deceased donor transplants more than doubled. In 2025, overall kidney transplants declined for the first time this century due to a drop in deceased donations making the need to increase living donation more urgent than ever.
What the LOVE Act Does
The Living Organ Volunteer Engagement (LOVE) Act (H.R. 7581), introduced by Rep. Nicole Malliotakis (R-NY) and Rep. Josh Gottheimer (D-NJ), amends the living donor provisions of the Medicare statute to create a dedicated 8-year Living Kidney Transplant Facilitator (LKTF) training program to help patients with End Stage Kidney Disease (ESKD) and advanced Chronic Kidney Disease (CKD) successfully receive a living donor kidney transplant.
Today, federal support to help patients find a living donor and guide donors through the complex transplant process remains limited.
The legislation enables Medicare-approved transplant hospitals to:
Today, federal support to help patients find a living donor and guide donors through the complex transplant process remains limited.
The legislation enables Medicare-approved transplant hospitals to:
Train Living Kidney Transplant Facilitators
Transplant hospitals can employ qualified individuals to train facilitators, including friends, family members, and community advocates, to help transplant candidates identify a qualified living donor and support the donor through the transplant process. Trainers provide initial instruction and remain available to support facilitators throughout the process, ensuring continuity and increasing the likelihood of successful donation.
Help patients identify living donors
Facilitators work with patients to map their personal networks, form a small team of trusted advocates, and develop the language, strategy, and outreach needed to spread awareness about living donation — through social media, community gatherings, one-on-one conversations, and targeted messaging within professional and social networks — to increase the likelihood of finding a match.
Guide living donors through the transplant process
Facilitators assist prospective donors in navigating the complex medical, logistical, and personal steps required for donation, from evaluation through surgery.
Provide reimbursement for facilitator training and support
The bill provides that Medicare will reimburse transplant hospitals for the reasonable costs of operating a facilitator training program, including ongoing guidance and counseling from trainers. Eligible facilities include Medicare-approved transplant programs that meet federal regulatory requirements and provide solid organ transplant services.
The LOVE Act focuses specifically on kidneys because of the direct connection between kidney transplants and Medicare-funded dialysis spending. The program's model, however, has the potential to be applied to other organs in future legislation.
Read KTC'S Whitepaper
View Here
Read KTC's LOVE Act Explainer
View Here
Read the LOVE Act Legislative Text
View Here
Proven Impact:
Saving Lives and Saving Costs
Saving Lives and Saving Costs
When patients and donors receive hands-on support, living donor transplants increase significantly. A Johns Hopkins study found that nearly 50% of patients working with trained facilitators identified a living donor, compared with zero among those without support. A University of Alabama Birmingham study found facilitator programs increased donor screenings 9-fold and approved donors 7-fold. Organizations like Project Renewal in New York have achieved similar results locally.
Public willingness is high. A Mayo Clinic survey found 84% of people would donate to a friend or family member and 49% to a stranger.
Living donation also saves the federal government money. Medicare spends over $130 billion a year (24% of total spending) on kidney disease. Each transplant saves Medicare an estimated $800,000 over ten years compared to ongoing dialysis. Doubling living donor transplants to 12,000 per year could reduce Medicare spending by $6.6 billion over the next decade.
Medicare already reimburses costly activities for deceased donation, including organ recovery, preservation, and private air transport costing tens of thousands per case. Adding reimbursement for the far more modest cost of training living donor facilitators is a practical next step.
Public willingness is high. A Mayo Clinic survey found 84% of people would donate to a friend or family member and 49% to a stranger.
Living donation also saves the federal government money. Medicare spends over $130 billion a year (24% of total spending) on kidney disease. Each transplant saves Medicare an estimated $800,000 over ten years compared to ongoing dialysis. Doubling living donor transplants to 12,000 per year could reduce Medicare spending by $6.6 billion over the next decade.
Medicare already reimburses costly activities for deceased donation, including organ recovery, preservation, and private air transport costing tens of thousands per case. Adding reimbursement for the far more modest cost of training living donor facilitators is a practical next step.
